Billing Specialist

📋 Description

• Review and address coding issues identified in billing systems before claim submission.

• Detect and rectify missing information, demographic discrepancies, and coding errors.

• Ensure claims are submitted accurately and within payer deadlines.

• Validate the use of CPT, ICD-10, and modifiers to ensure billing compliance.

• Monitor and resolve billing issues that arise within the EHR system.

• Collaborate with clinical and administrative teams to gather any missing documentation.

• Maintain organized billing queues by proactively resolving preventable claim holds.

• Escalate recurring workflow challenges that affect claim submission efficiency.

• Process claims that require secondary insurance billing and coordination of benefits.

• Attach primary EOB documentation as necessary.

• Follow up on secondary claims until resolution is achieved.

• Ensure accurate payer sequencing and routing of claims.

• Track billing percentage metrics and identify trends affecting claim holds.

• Support operational reporting related to pre-submission performance.

• Suggest process improvements to minimize avoidable delays.

• Maintain precise documentation and records of billing activities.

⛳️ Requirements

• At least 1 year of experience in medical billing or revenue cycle management.

• Strong comprehension of pre-submission workflows and claim editing processes.

• Experience with EHR platforms.

• Knowledge of CPT, ICD-10, and modifier applications.

• Excellent organizational skills and a keen attention to detail.

• Outstanding written and verbal communication skills in English.

• Ability to handle multiple priorities in a fast-paced setting.

• Nice-to-Haves (Preferred)

• Experience in ABA or behavioral health billing.

• Familiarity with secondary billing and coordination of benefits processes.

• Experience with TRICARE, HMSA, Medicaid, and commercial insurers.

• Exposure to high-volume healthcare billing operations.

• Tools Proficiency

• Candid or similar billing platforms.

• EHR systems.

• Google Workspace.

• Microsoft Excel or Google Sheets.

• Payer portals.

🏝️ Benefits

• Competitive Salary: Based on experience and skills.

• Remote Work: Fully remote—work from anywhere.

• Team Incentives: Recognition for maintaining 100% CRM hygiene and on-time reporting.

• Generous PTO: In accordance with company policy.

• Health Coverage for PH-based talents: HMO coverage after 3 months for full-time employees.

• Direct Mentorship: Guidance from international industry experts.

• Learning & Development: Ongoing access to resources for professional growth.

• Global Networking: Connect with professionals worldwide.